| NPI | 1306365556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017044033) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2017044033) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209016570) | |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2021-06-03 |